International primary mental health and addiction context
Our common humanity compels us to respect people's universal aspiration for a better life, and to support their attainment of a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity1. In support of this, the Alma Ata declaration on primary health care was adopted internationally 30 years ago. This declaration recognises that mental and social wellbeing is a core component of health and the delivery of mental health care is an essential component of any primary care system2.
Mental health and addiction concerns affect hundreds of millions of people worldwide and, if left untreated, create an enormous toll of suffering, disability and economic loss. Integrating mental health and addiction into primary care facilitates person-centred and holistic services. Integrating mental health services into primary care is also the most viable way of ensuring that people have access to the mental health care they need; people can access mental health services closer to their homes thus keeping their families together, maintaining their daily activities, and avoiding the indirect costs associated with seeking specialist care. Furthermore, mental health services delivered in primary care settings minimise stigma and discrimination1.
Integrating mental health and addiction services into primary care is the most viable and cost effective way of ensuring that people get the mental health and addiction care they need at the earliest opportunity. Targeted services for people with mild to moderate mental health and addiction issues provides cost and outcome benefits by reducing the likelihood that people's mental health and addiction concerns will become more severe, and thereby reducing the need for more expensive secondary services.
Before mental health integration can be reasonably expected to flourish however, primary health care systems must be strengthened. There is a lot of activity occurring internationally to this end, with a number of best practice examples of this outlined in the 2008 WHO and Wonca document Integrating mental health into primary care: a global perspective.
References
- World Health Organization and World Organization of Family Doctors. 2008. Integrating mental health into primary care: a global perspective.
- International Conference on Primary Health Care, Alma-Ata, USSR, 6-12 September, 1978. Declaration of Alma-Ata.